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Deepthi M Reddy, Mohammed Naseemuddin, John O Mason, Jacob J Yunker, Duncan A Friedman; Choroidal Melanoma Biopsy During Brachytherapy Using 25-Gauge Vitrectomy Technique: Clinical Experience. Invest. Ophthalmol. Vis. Sci. 2014;55(13):2327.
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© ARVO (1962-2015); The Authors (2016-present)
To report the safety and efficacy of a novel surgical technique for the biopsy of choroidal melanomas utilizing 25-gauge vitrectomy during brachytherapy.
A retrospective consecutive interventional case series of 17 consecutive eyes that underwent biopsy of choroidal melanoma during brachytherapy from September 2012 to May 2013, was performed to identify postoperative occurrence of vitreous hemorrhage, tumor seeding or other complications, as well as the adequacy of biopsy aspirate for genetic analysis.
During the 8-month study interval, 0/17 (0%) eyes had the complication of postoperative vitreous hemorrhage, or tumor seeding of vitreous cavity or external extraocular tissue. Adequate tissue biopsy aspirate was obtained in 17/17 (100%) of cases for RNA-based gene expression assay. 4/17 (23.5%) were identified as Class 2 and 13/17 (76.5%) were identified as Class 1. Postoperative visual acuity was stable in 14/17 eyes (82.3%) and improved in 3/17 (17.7%) eyes.
This study suggests that 25-gauge vitrectomy biopsy technique, which results in controlled hemostasis and adequate biopsy samples, is an effective alternative to transvitreal or transscleral fine-needle aspiration biopsy techniques for choroidal melanoma biopsy. No short or long-term complications were noted.
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